Late Loss Functional Status ADL Flow Sheet (OSA)
Updated 2024
Briggs Late Loss Functional Status ADL Flow Sheet (OSA)is for use in coding Section G of the Optional State Assessment (OSA) for states using the MDS 3.0 Item Set for Medicaid case mix reimbursement.
This monthly flowsheet (Front side covers for first 15 days of the month with the reverse side covering days 16 through 31) is used to record a resident's functional status in these 4 domains:
• | Bed Mobility | • | Transfers |
• | Eating | • | Toilet Use |
Size: 11" x 8 ½"
Print: Black ink, 2-sided
Punching: 5-holes top and side
Packaging: 100 per pad